HomeMy WebLinkAboutAUTH-04-2016-071352.TIF pA .. CATAWBA COUNTY Case# _ __ _ , __
T r G Public Health Department Subdivision KOOL VALLEY
es /:
Health Division PIN# 372415545703
&w' PO Box 389. 100-A Southwest Blvd,Newton,NC 28658
LOT# 1-8
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NAME ON PERMIT: JEREMY HARSTICK, 3351 30TH ST NE, HICKORY NC 28601
Site Address: 3351 30TH ST NE, HICKORY NC 28601
Property Size: Square Feet:40,075.20 Acres:0.92
Directions: Springs Rd/to Kook Park Rd/ right on 18th St NE / right 34th AVe NE/ right on 30th St NE/ 1st house on right
Owner/Authorized Representative Acknowledgement of Permit Receipt
I certify that I am the owner or authorized agent(owner's authorization required) representing the owner of the
y roperty described above.
kAs the property owner or authorized representative, I have received the above referenced permit(s) as
requested in the application for service RBPR-10-2015-22632
`� by the following method(s):
, Received in Person
Facsimile Transmittal (Return form with signature required)
Electronic Image Transmittal/ E-mail (Return receipt required)
tAs the property owner or authorized representative I have reviewed and understand the specific conditions
of the permit issued, and further understand that all applicable regulatory requirements specified under the North
Carolina Laws and Rules for Sewage Treatment and Disposal Systems (15A NCAC 18A .1900), and/or
Well Construction Standards (15A NCAC 2C .0100), shall apply to the issuance of this permit and the
construction of the wastewater system and/or water supply well permitted.
Permit Issue Date: 04/19/2016
Owner/Authorized Representative Signature
10/140 ' • ._ ,
Date 5- /1,(:)/6
Documentation of Permit(s) Transmittal
(permit transmitted by electronic or other means)
Permit transmitted by (name of person sending permit)
Signature Date/Time
Method: Fax Email US Mail Other
Owner's request to send by the above indicated method of transmittal in lieu of signature
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chperniit 04/21/2016 08:55 Page 3 of3
snA CATAWBA COUNTY 0 f -0' 1' Q Case# AUTH-04-20 1 6-07 1 3 52
a Public Health Department 134.1.; r,. Subdivision KOOL VALLEY
< s H Environmental Health Division tc_e! r • PIN/ 372415545703
PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 o ego.i• 0 LOT# 1-8
4342 fi
Q .
NAME ON PERMIT: JEREMY HARSTICK, 3351 30TH ST NE, HICKORY NC 28601
Site Address: 3351 30TH ST NE, HICKORY NC 28601
Property Size: Square Feet:40,075.20 Acres:0.92
Directions: Springs Rd/to Kook Park Rd/ right on 18th St NE / right 34th AVe NE/ right on 30th St NE/ 1st house on right
Authorization to Construct Permit
Authorization to Construct Wastewater System (Required for Building Permit)
* See site plan and number of additional attachments ( )_
Proposed Wastewater System: 25% REDUCTION Wastewater Flow 600 g.p.d
Type: IIIB - SYSTEM W/SINGLE EFFLUENT PUMP
Soil LIAR: 0.3 g.p.d./ft2
Permit Category: Expansion
Type of Facility: Primary Residence - house
Basement? Yes Basement Plumbing? Yes Bedrooms: 5
Wastewater System Requirements
Tank Size: New Tank 1,500 gal Pump Tank 1,000 gal Grease Trap gal
Dosing Volume 243 gal Pump Specs: 57 GPM @ 29 TDH
Pressure Head _ 2 ft Draw Down in
Drainfield: Total Area 960 sq ft Total Length: 320 ft Maximum Trench Depth 30 in
Aggregate Depth in Trench Width 3 ft
Minimum Soil Cover 12 in Minimum Trench Separation 9 ft on center
Number of Drain Lines 5
Distribution: Pressure Manifold
Pre Treatment: NONE
PUMP REQUIRED
Additional Specifications:
Landscaping or other site alterations that potentially divert groundwater or surface water toward the septic system, or prevent
proper drainage away from the septic system, including the direction of gutter flows or foundation drains, is not approved, and
may result in failure to approve the initial system installation, or the suspension/revocation of existing permits.
»»> DO NOT INSTALL SYSTEM UNDER WET CONDITIONS ««<
Proposed Repair
System Class: IIIB Proposed System: 25% REDUCTION Distribution Type:: Pressure Manifold
Soil LTAR: 0.3 g.p.d./ft2
PUMP REQUIRED
chperntit 04/21/2016 08:56 Pagc 1 of4
eA CATAWBA COUNTY Case# AUTH-04-2016-071352
Public Health Department Subdivision KOOL VALLEY
4 , 2—: Environmental Health Division PIN# 372415545703
� PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 LOT# 1-8
/842 „,
NAME ON PERMIT: JEREMY HARSTICK, 3351 30TH ST NE, HICKORY NC 28601
Site Address: 3351 30TH ST NE, HICKORY NC 28601
Property Size: Square Feet:40,075.20 Acres:0.92
Directions: Springs Rd/to Kook Park Rd/ right on 18th St NE / right 34th AVe NE/ right on 30th St NE/ 1st house on right
The issuance of this permit by the Health Department does not guarantee the issuance of other permits. It is the responsibility of
the applicant/property owner to insure that all Catawba County Planning/Zoning and Building Inspections requirements are met.
This Authorization to Construct Permit is subject to revocation if the site plan,plat or the intended use changes,or if site
conditions are altered. The Authorization to Construct Permit is not affected by a change in ownership of the property. This permit
was issued in compliance with the provisions of the North Carolina 'Laws and Rules for Sewage Treatment and Disposal Systems' (15A
NCAC 18A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will
continue to function satisfactorily for any riven period of time
Megen McBride 04/19/2016
AUTHORIZED STATE AGENT APPROVAL DATE
Permit Expiration Date: 04/19/2021
No grading or construction activity is allowed in areas designated for system and repair without approval of the Health Department.
ehpermii 04/21/2016 08:56 Page 2 of4
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